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  • Image not available. The etiology of infectious diarrhea includes bacteria, viruses, and protozoans. Viral infections are the leading cause of diarrhea in the world.
  • Image not available. Fluid and electrolyte replacement is the cornerstone of therapy. Oral rehydration therapy is preferred in most cases of mild and moderate diarrhea. The necessary components of oral replacement therapy are glucose, sodium, potassium, chloride, and water.
  • Image not available. Antimicrobial therapy often is not indicated for enteritis because many cases are mild and self-limited or are viral in nature.
  • Image not available. Diarrheal illness can be prevented by following simple rules of personal hygiene and safe food preparation.
  • Image not available. The most common pathogens for traveler's diarrhea include enterotoxigenic Escherichia coli, Shigella, Campylobacter, Salmonella, and viruses.
  • Image not available. Patient education in prevention strategies and self-treatment of traveler's diarrhea is recommended. Prophylaxis with antibiotics is not recommended in most situations.
  • Image not available. Common pathogens responsible for food poisoning include Staphylococcus, Salmonella, Shigella, and Clostridium.

On completion of the chapter, the reader will be able to:

  • 1. Describe the incidence of gastroenteritis and diarrheal illness in the United States.
  • 2. Assess the value of routine stool cultures in the diagnosis of diarrheal illness.
  • 3. Differentiate oral rehydration formulations based on electrolyte and carbohydrate content.
  • 4. Explain with which syndromes antibiotic therapy has been proven to be of value and should be prescribed.
  • 5. Explain the rationale for appropriate antimotility agent use in diarrheal illness.
  • 6. Recommend prevention and treatment strategies for cholera.
  • 7. Differentiate between pathogenic features of diarrhea-causing Escherichia coli disease.
  • 8. Discuss the clinical presentation of enterohemorrhagic E. coli 0157:H7 disease.
  • 9. Identify the incidence of antibiotic associated diarrhea caused by Clostridium difficile, in the context of all antibiotic-associated diarrhea.
  • 10. Outline a treatment strategy for C. difficile-related pseudomembranous colitis.
  • 11. Identify the appropriate patient population and clinical situation in which antibiotics should be used for the treatment of Salmonellosis.
  • 12. Recommend appropriate antibiotic therapy for typhoid fever.
  • 13. Compare the seasonal relationships of bacteria and diarrheal diseases in the diagnosis of diarrhea pathogenesis.
  • 14. Recite the four major viruses responsible for gastroenteritis in American adults and children.
  • 15. Describe the pathogenesis of traveler’s diarrhea.
  • 16. Outline a prevention strategy for traveler’s diarrhea for travel to central American countries.
  • 17. Describe the temporal timing relationships of bacterial causes of food poisoning and the severity and onset of symptoms.
  • 18. Explain the role of antibiotics in the treatment of common food poisoning.

Gastrointestinal (GI) infections encompass a wide variety of syndromes from mild gastroenteritis to life-threatening systemic disease. Dehydration from GI infections is the second leading cause of morbidity and mortality worldwide, and infants and children younger than age 5 years are at the highest risk. From 1992 to 2000, the median incidence of diarrhea for all children younger than age 5 years was 3.2 episodes per child per year. The incidence of diarrhea was higher in ...

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